Treatment retention and medication compliance in adults outpatients with post-traumatic disorder with and without eye movement desensitization and reprocessing (EMDR) therapy
Description
Background:
Although trauma-focused psychotherapy is considered as the first-line treatment, a large number of patients with post-traumatic stress disorder (PTSD) received psychotropic medications in psychiatric facilities. However, little is known about the efficacy and interactive effects brought by combined treatment of these different therapy options. This study retrospectively examined treatment retention and medications compliance between outpatients with PTSD with or without eye movement desensitization and reprocessing (EMDR) therapy.
Methods:
A total of 194 outpatients with PTSD received psychopharmacological treatment at a psychiatric department of university-affiliated hospital in South Korea during 10 year period About 40% (n=75) also received at least one session of EMDR with concomitant pharmacotherapy and another 60% (n=119) received pharmacotherapy alone. The demographic and clinical data including Clinician-administered PTSD Scale (CAPS), the Clinical Global Scale, Symptom CHecklist-90-Revised (SCL-90-R), and the Compliance Rating Scale were compared between groups and the Kaplan Meyer survival analysis was conducted where the outcome was dropout from the treatment for 24 months.
Results:
Compared to those with pharmacotherapy alone, combined therapy group stayed significantly longer in treatment (U=7371, df+180, p=.008) and higher level of compliance to medication (t=2.69, df=180, p=.008). The EMDR group stayed median estimate of 12 months (95% CI=1.03-2.97) in pharmacotherapy along group. There was no difference overall severity of PTSD and other psychological symptoms or respond to treatment between groups. The Kaplan Meier survival analysis demonstrated that EMDR group was associated with lower dropout as a function of outpatient stay (time). Two groups were separated early and remained separate (log rank p<o.001).
Conclusion:
These results indicate that adding EMDR to pharmacology may enhance treatment adherence although other trauma-focused psychotherapies may as well be. Further studies are needed to explore the mediating variables such as therapeutic alliance affecting treatment retention and compliance for the pharmacological treatment of PTSD.